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169 Greenfield Road Lot 39Davie County, NC Tax Parcel Report Monday, December 19, 2016 1s1 176 � Ir a � --- 111 — Ot 169 Z ` W. ------ -Lu - --- ---------- 164 9s�t8 All data is provided as Is withoutwemanty or guarantee of any wnd ehhereapressed or Implied Including but not limited to the Davie County, implied mmanIles ofinerchardabgry wrKorthlness for a paNwlaruse. All users of Davie Gomdys GIS websie shall hold harmless the l'� County of Davie. KoCarollm, hs agents, mnsubants, contractors or employees from any and all claims oreauses of action due to �ODN2� NC oransing out of the use or Inability to use Me GIS data provided by this whale. WARNING: THIS IS NOT A SURVEY P._arcelInformatlon__LL_ Parcel Number: D301OA0039 Township: Clarksville NCPIN Number. 5822153004 Municipality: Account Number: 8301358 Census Tract: 37059-801 Listed Owner 1: MORGAN ISSAC ALEXANDER Voting Precinct: CLARKSVILLE Mailing Address 1: 169 GREENFIELD ROAD Planning Jurisdiction: Davie County City: MOCKSVILLE Zoning Class: DAVIE COUNTY R-20 State: NC Zoning Overlay: Zip Code: 27028 Voluntary Ag. District No Legal Description: LOT 39 DUTCHMAN HILLS Fire Response District: WILLIAM R. DAVIE Assessed Acreage: 0.92 Elementary School Zone: WILLIAM R DAVIE Deed Date: 912012 Middle School Zone: NORTH DAVIE Deed Book IPage: 009010845 Soil Types: MnB2 Plat Book: 0007 Flood Zone: Plat Page: 0190 Watershed Overlay: DAVIE COUNTY Building Value: Outbuilding & Extra Freatures Value: Land Value: Total Market Value: Total Assessed Value: 9s�t8 All data is provided as Is withoutwemanty or guarantee of any wnd ehhereapressed or Implied Including but not limited to the Davie County, implied mmanIles ofinerchardabgry wrKorthlness for a paNwlaruse. All users of Davie Gomdys GIS websie shall hold harmless the l'� County of Davie. KoCarollm, hs agents, mnsubants, contractors or employees from any and all claims oreauses of action due to �ODN2� NC oransing out of the use or Inability to use Me GIS data provided by this whale. DAVIE COUNTY HEALTH DEPARTMENT Environmental Health Section P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 IMPROVEMENT(OPERATION PERMIT Account #: 990001248 Tax PIN/EH #: 5822-15-3004 Billed To: Mike Hester Building Co. Subdivision Info: Dutchman Hills Lot # 39 Reference Name: Location/Address: Greenfield Drive -27028 Proposed Facility Residence Property Size: see map ATC Number: 3766 **NOTE** This Improvement/Operation Permit DOES NOT authorize the construction of a septic tank system or any wastewater , system: An AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION must be obtained from this Department prior to the construction/installation of a system or the issuance of a building permit (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS PERMIT IS SUBJECT TO REVOCATION IF SITE PLANS OR THE INTENDED USE CHANGE. YOUR. WASTEWATER SYSTEM CONTRACTOR MUST SEE THIS PERMIT BEFORE INSTALLING SYSTEM Residential Specification: Building Type k0l,)SC, #People #Bedrooms 3 #Baths 2— Dishwasher: Dishwasher: Garbage Disposal: ❑ Washing Machine: 13 Basement w/Plumbing: Q Basement/No Plumbing: ❑ Commercial Specification: Facility Type #People_ #People/Shift #Seats Industrial Waste: ❑ Lot Size Oa3 AAType Water Supply Design Wastewater Flow (GPD) lapo Site: New Repair ❑ System Specifications: Tank Size ICCO GAL. Pump Tank _ GAL. Trench Width �v Rock Depth I2 Linear Ft. -3&,3t Other:sl� Required Site Modifications/Conditions: NyaL D,J Ca»� V oe1�vFG CJ � 'Vey& 10' OAF WP IMPROVEMENT/OPERATION PERMIT LAYOUT - APPROVED EFFLUENT FILTER. RISER(S) IF 6 " BELOW FINISHED GRADE. ****NOTICE: Contact a representative of the Davie County Health Department for final inspection of this system between 8:30 a.m. to 9:30 a.m. or 1:00 p.m. to 1:30 p.m. on the day of installation. Telephone # is (336)751-8760.**** �,*i - _. .1HO � FOD t_laEs 10 ORDe t I=c�toJ Po r�p - g0 ,L4 &s�-w.er-�r � I C Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: DAVIE COUNTY HEALTH DEPARTMENT / Environmental Health Section. / P. O. Boa 848/210 Hospital Street Mocksville, NC 27028 (336)751-8760 Account #: 990001248 Tax PIN/EH #: 5822-15-3064 Billed To: Mike Hester Building Co. Subdivision Info: Dutchman Hills Lot # 39 Reference Name: ' Location/Address: Greenfield Drive -27028 rroposea racmty rtesiaence ATC Number: 3766 bize: see AUTHORIZATION FOR WASTEWATER SYSTEM CONSTRUCTION **NOTE** This Authorization for Wastewater System Construction MUST BE ISSUED by the Davie County Environmental Health Section prior to issuance of any building permit(s). This Form/Authorization Number should be presented to the Davie County Building Inspections Office when applying for building permit(s) (in compliance with Article 11 of G.S. Chapter 130A, Wastewater Systems, Section .1900 Sewage Treatment and Disposal Systems). THIS AUTHORIZATION FOR WASTEWATER CON UCTI N S VALID FOR A PERIOD OF FIVEYEARS. Environmental Health Specialist's Signature: Date: 561"q CERTIFICATE OF COMPLETION **NOTE** The issuance of this Certificate of Completion shall indicate the system described on ImprovementlOperation Permit has been installed in compliance with Article 11 of G. S. Chapter 130A, Section .1900 "Sewage Treatment and Disposal Systems," but shall in NO WAY be taken as a guarantee that the system will function satisfactorily for any given period of time. / / X Septic System Installed By: Environmental Health Specialist's Signature: DCHD 05/99 (Revised) Date: D 0, 930. AC. MFrJT S 84 '20' 50' N 270 00 Li o �> w +� ', co LOT #39_ KM 0, 930 AC. ' S 84 20'50' co ` � 1 LOT #38 L, �, W .;. o 0. 930 AC, 1 ) Q S 84 - 20, 50' E j n�. 270. 39 L' lr4 ATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC APR 27 2��4 . Davie County, Health Department EnvironmetaiHeaith Section P.O. Box 848/210 ,Hospital Street EMARONMENTALHEALTH Mocksville, NC 27028 DAVIEcouNTY (336) 751-8760 ***IMPORTANT*** THIS APPLICATION CANNOT BE PROCESSED UNLESS ALL THE REQUIRED INFORMATION IS PROVIDED.' Refer to the INFORMATION BULLETIN for instructions. 1. Name to be Billed M 116r tf&-y7 "n (3c4l(I:iv�cc�.ntact Person Mailing Address Si (t L/7/If Sk- ;Ck' [•IL l` - .Roma Phone City/State/ZIP Lt- - S_ y (-.. 7 --) t G a./ Business Phone 3 � to • � `% � - �}. �= t/� ' 2. Name on Permit/ATC if Different than, Above - - .Mailing Address - - City/State/Zip - 3. A lication.For: .... � `y1n� - PP �ursite Evaluation L,y�[mprovement Permit/ATC ❑ Both 4. - System to Service: �House ❑ Mobile Home ❑r Business ❑ Industry, ❑ Other - S. Typesystem requested: ial'Conventional ❑ conventional modified ❑ innovative - 6. If Residence: # People-.., # Bedrooms # Bathrooms :, ishwasher []Garbage Disposal 9<1��shing Machine a38asement/Plumbing "- ❑Basement/No Plumbing 7.If Business/Industry /Other: verify type #People # Sinks # Commodes # Showers #Urinals. - - # Water Coolers . IF FOODSERVICE: #��YCoat�Seats Estimated Water Usage (gallons per day) V - 3. Type of water supply: unty/City ❑ Well ❑ Community — 9. Do -you anticipate additions or expansions of the facility this System is intended to serve? ❑ Yes o If yes, what type? ***IMPORTANT*** CLIENTS MUST COMPLETE THE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BE SUBMITTED by the client with THIS APPLICATION. -- ., Property Dimensions: -. t �WRITEODIREICTIONS (from Mrocksville) to PROPERTY: Tax Office PIN cff-7 S3 o D /S0 ii-huiX40 Property Address: Road Name C-y.e-ON •tp�i/,/X.l l.(ffn ® 499--t yryeq'jC4•/�� city/zip /h �l(S err1e a ��e�y 1 00h 14 /t 11S 4 In, J E JC If in a Subdivision provide information, as follows: ©`1 �y een •F / Dy T� 4 9 Name: MC4 v1 1 f l I S ©`1 0 t Section: Block: Lot L; Date home corners flagged: Cr/d ='r'` This is to certify that the information provided is correct to the best of my knowledge. I understand that any permit(s) issued hereafter are subject to suspension or revocation, if the site plans or intended use change, or if the information submitted in this application is falsified or changed. I, also, understand that I am respousible for all charges incurred from ` this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located in Davie County and owned by to conduct all 1testing procedures as necessary to determine the site suitability. DATE ` 1 — -� -7 — U t( SIGNATU THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (In Inde all of the following: Existing and proposed property lines and dimensions, structures, setbacks, and septic locations). J Site Revisit Charge / Client Notification Date: EHS: c7 Sign given Account No. Revised DCHD (05/03 Invoice No. / L �— APPLICATION FOR SITE EVALUATION/IMPROVEMENT PERMIT & ATC r D �; ^ r- - � Davis County Health Department __... EnWmirmenta/Hea/th Sectfon /",,5e Lw � P.O. Box 868/210 Hospital atreet �IPk C /� a Mockeville, RC 27028 i/S (336) 751-8760 ***Ii'.PORTANT*** THIS APPLICATION CANNOT BS PROCESBZD UNLE88 ALL THE REQUIRED nVfORMATIOH I8 PROVIDED. Refer to the IRMPMTICH BULLETIN for instructions. 1. Raeo to he Billed _eMataoteon, J Hollins Address 7 9! ela c� some Horne _ 99p�r t o g City/mt.t./ilp t _A_//dJiyGQ7_ Me, oC %oaPJ Business Hwa. r- 2. How on permit/ATO is Dieeerent than Above Roiling Address City/Etats/Zip 3. Application for: p fits Evaluation ❑ improvement Permit/ATC 13 Both 4. system to marviw, w6ouse ❑ Mobile Homs ❑ Business ❑ Industry O Other 5. If Residence: 1 People 1 Bedrooms / Bathrooms D Dishwasher D garbage Disposal D washing Raahins O Basswat/plumbing D Basomwit/No plumbing e. 'ie Business/Industry/other, speniey typo / Commode. 1 shower$ / people / sinks / Urinals 1 water Coolers Ir rOOD8ERVICE: # Seats Estimated Rater Usage (gallons per day) v. Type of water supply: 8 County/City ❑ Well ❑ Community e. Do you anticipate additions or expamlons of the facility this system b Intended to serve? ❑ Yes ❑ No If yes, what type? ***IMPORTANT*** CLIENTS MUSTCOMPLETETIIE REQUIRED PROPERTY INFORMATION REQUESTED BELOW. Either a PLAT or SITE PLAN MUST BESVBMITIED by the client with THIS APPLICATtnN_ Property Dlmensiomi:/ 1.1;<9 9.3 A2'y_5 Tar O(Rce PIN: a6--'3'qa - IU - � ?5,5- 9� Property Address: Road Name 0Z MALL YnN ` A clty/zlpJr/a i,L�_ �JP,�7�f( If In a Subdivision provide Information, as follows: Name: Section: Block: Lot: 3` WRITE DIRECTIONS (from MoekrAlle) to PROPERTY: /m/ Nose, T LIN Date Property Flagged: �U /nCr f�C✓KCrJ1e�/r This is to certify that the Information provided is correct to the best of my knowledge. I understand that any permit(s) Issued hereafter are subject to suspension or revocation, if the site plans or Intended we change, or If the Information submitted In this application la falslRed or changed I, also, understand that I am responslhlejor afl charges Incurredjrom this application. I, hereby, give consent to the Authorized Representative of the Davie County Health Department to enter upon above described property located In Davie County and owned by to conduct OR testing procedures as necessary to determine the site sWtsloRly. DATEO- r2eQQU THIS AREA MAY BE USED FOR DRAWING YOUR SITE PLAN (Joel e�a11 of the following: Existing mud proposed property lines and dimensions, structures, setbacks, and septic locado Revised DCHD (07/99) Site Revisit Charge Date(s): I Client Notification Date: IAccount No. Invoice No. Z� DAVIE COUNTY HEALTH DEPARTMENT #' Environmental Health Section Soil/Site Evaluation APPLICANT INFORMATION PROPERTY INFORMATION Account #: 989900111 Tax PIN/EH #: X5822=146855.39 Billed To: 'Gray Potts' Subdi4ision Info: ; Dutchman Hills Lot # 39 Reference Name: Gray Potts Location/Address: Eatons Church Road -27028 Proposed Facility:, Residence Property Size:'. 51 Acres - Date Evaluated: U 0� Water Supply: On -Site Well Community Public /• Evaluation By Auger Boring Pit Cut FACTORS l 2- g: q ., . 5 6. 7 Landscape position : L _ .. Slope % HORIZON I DEPTH . 1 Texture group t^ i G Consistence . ; Structure . -... . , . tr_ Mineralogy 1 HORIZON II DEPTHI ' 3l7 Zq- Texture group Consistence f Structure ... k ... Mineralogy (: HORIZON III DEPTH + Texture group Consistence. Structure , Mineralogy HORIZON IV DEPTH Texture group Consistence Structure Mineralogy SOIL WETNESS, . RESTRICTIVE HORIZON SAPROLITE CLASSIFICATION 5 LONG-TERM ACCEPTANCE RATE ' SITE CLASSIFICATION:5 EV ALUATION BY:' LONG-TERM ACCEPTANCE RATE: �•3�' O OTHER(S) PRESENT: REMARKS:. LEGEND. Landscape Position .; R - Ridge : S - Shoulder L - Linear slope FS - Foot slope N - Nose slope CC - Concave slope CV - Convex slope .. T - Terrace FP - Flood plain H.- Head slope Texture . ... y, sand SL l Sandy loamLoam SI - Silt SICL Silty clayloam SIL - Silty CL - Clay loam' SCL - Sandy clay loam' SC =Sandy clay SIC - Silry clay C -Clay CONSISTENCE Moist VFR - Very friable FR - Fnable FI - Firm: VFI Very firm EFI - Extremely firm Wet NS - Non sticky 'SS - Slightly sticky S - Sticky VS - Very Sticky NP - Non plastic SP - Slightly plastic P. - Plastic VP - Very plastic Structure . SC - Single grain M - Massive CR - Crumb OR - Granular ABK - Angular blocky SBK - Subangular blocky PL - Platy PR - Prismatic Mineraloev 1:1, 2:1, Mixed Notes Horizon depth - In inches Depth of fill - In inches Restrictive horizon - Thickness and inches from land surface Saprolite - S(suitable), U(unsuitable) Soil wetness - Inches from land surface to free water or inches from land surface to soil colors with chroma 2 or less Classification - S(suitable), PS(provisionally suitable), U(unsuitable) LTAR - Long-term acceptance rate - gal/day/ft2 , DCHD 05/99 (Revised)